Despite the enormous progress in prevention and treatment, tuberculosis disease remains a leading cause of death worldwide and one of the major sources of concern is the drug resistant strain, MDR-TB (multidrug resist...Despite the enormous progress in prevention and treatment, tuberculosis disease remains a leading cause of death worldwide and one of the major sources of concern is the drug resistant strain, MDR-TB (multidrug resistant tuberculosis) and XDR-TB (extensively drug resistant tuberculosis). In this work, we extend the standard SEIRS epidemiology model of tuberculosis to include MDR-TB. For that, we considered compartments of susceptible, exposed, infected, resistant to a first line of treatment and recovered humans and we modeled the natural growth, the interactions between these populations and the effects of treatments. We calculate the basic reproduction number, , using the next generation method. The DFE and the EE are established and their stability analysis done to show that they are locally and globally asymptotically stable. Numerical analysis for the model with and without delay is done and demonstrated that in the case of patients with both active tuberculosis and MDR tuberculosis, both strains will still persist due to lack of permanent immunity to tuberculosis while the recovered can still lose their immunity to become susceptible again.展开更多
Background: The emergence of multidrug resistant tuberculosis (MDR-TB) and extensively drug- resistant tuberculosis (XDR-TB) has highlighted the need for early accurate detection and drug susceptibility. Objective: Th...Background: The emergence of multidrug resistant tuberculosis (MDR-TB) and extensively drug- resistant tuberculosis (XDR-TB) has highlighted the need for early accurate detection and drug susceptibility. Objective: The purpose of the present study was to evaluate the accuracy of GeneX-pert MTB/RIF assay for the detection of Mycobacterium tuberculosis and rifampicin resistance. Methodology: This cross sectional study was done in the Department of Microbiology at Sir Salimullah Medical College, Dhaka and National Institute of Chest Disease & Hospital (NIDCH), Dhaka during the period of January 2014 to December 2014 for a period of 1 (one) year. Sputum samples from suspected MDR-TB patients were collected by purposive sampling technique from OPD of Sir Salimullah Medical College (SSMC) and NIDCH. Microscopy, liquid culture in liquid MGIT 960 media and GeneXpert MTB/RIF were done for MTB diagnosis and detection of rifampicin resistance. MGIT 960 media were also used for determination of drug resistance. Result: Liquid culture yielded higher growth (68%) from 100 samples while GeneXpert MTB assay showed similar result (67% positive and 33% negative). Drug susceptibility test in MGIT 960 media showed that out of 68 positive cases Rifampicin resistant cases were 15 (22.05%) whereas GeneXpert MTB assay detected 14 (20.89%) were Rifampicin resistant out of 67 MTB positive samples. When compared to liquid culture the calculated sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy of GeneXpert MTB were 98.52%, 100%, 96.96%, 100% and 99%. Conclusion: GeneXpert MTB/RIF assay is high detection rate of pulmonary tuberculosis and multidrug resistant tuberculosis.展开更多
文摘Despite the enormous progress in prevention and treatment, tuberculosis disease remains a leading cause of death worldwide and one of the major sources of concern is the drug resistant strain, MDR-TB (multidrug resistant tuberculosis) and XDR-TB (extensively drug resistant tuberculosis). In this work, we extend the standard SEIRS epidemiology model of tuberculosis to include MDR-TB. For that, we considered compartments of susceptible, exposed, infected, resistant to a first line of treatment and recovered humans and we modeled the natural growth, the interactions between these populations and the effects of treatments. We calculate the basic reproduction number, , using the next generation method. The DFE and the EE are established and their stability analysis done to show that they are locally and globally asymptotically stable. Numerical analysis for the model with and without delay is done and demonstrated that in the case of patients with both active tuberculosis and MDR tuberculosis, both strains will still persist due to lack of permanent immunity to tuberculosis while the recovered can still lose their immunity to become susceptible again.
文摘Background: The emergence of multidrug resistant tuberculosis (MDR-TB) and extensively drug- resistant tuberculosis (XDR-TB) has highlighted the need for early accurate detection and drug susceptibility. Objective: The purpose of the present study was to evaluate the accuracy of GeneX-pert MTB/RIF assay for the detection of Mycobacterium tuberculosis and rifampicin resistance. Methodology: This cross sectional study was done in the Department of Microbiology at Sir Salimullah Medical College, Dhaka and National Institute of Chest Disease & Hospital (NIDCH), Dhaka during the period of January 2014 to December 2014 for a period of 1 (one) year. Sputum samples from suspected MDR-TB patients were collected by purposive sampling technique from OPD of Sir Salimullah Medical College (SSMC) and NIDCH. Microscopy, liquid culture in liquid MGIT 960 media and GeneXpert MTB/RIF were done for MTB diagnosis and detection of rifampicin resistance. MGIT 960 media were also used for determination of drug resistance. Result: Liquid culture yielded higher growth (68%) from 100 samples while GeneXpert MTB assay showed similar result (67% positive and 33% negative). Drug susceptibility test in MGIT 960 media showed that out of 68 positive cases Rifampicin resistant cases were 15 (22.05%) whereas GeneXpert MTB assay detected 14 (20.89%) were Rifampicin resistant out of 67 MTB positive samples. When compared to liquid culture the calculated sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy of GeneXpert MTB were 98.52%, 100%, 96.96%, 100% and 99%. Conclusion: GeneXpert MTB/RIF assay is high detection rate of pulmonary tuberculosis and multidrug resistant tuberculosis.
